MACON COUNTY GENERAL HOSPITAL INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MACON COUNTY GENERAL HOSPITAL INC (EIN 62-0988604)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-08-14
- IRS object ID
- 201332269349302763
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-08-14T14:15:17-05:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 E MAIN ST STE 200 PO BOX 1196 | AddressLine1 |
| City | BOWLING GREEN | City |
| State | KY | State |
| ZIP Code | 421021196 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 620988604 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MACON HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % THOMAS J KIDD CPA | InCareOfName |
| Name Control | MACO | NameControl |
| Phone | 6156662147 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 204 MEDICAL DRIVE | AddressLine1 |
| City | LAFAYETTE | City |
| State | TN | State |
| ZIP Code | 37083 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | THOMAS J KIDD | Name |
| Title | CFO | Title |
| Date Signed | 2012-08-10 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2707810111 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MACON COUNTY GENERAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DENNIS WOLFORD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 204 MEDICAL DRIVE | AddressLine1 |
| City | LAFAYETTE | City |
| State | TN | State |
| ZIP Code | 37083 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 12144462 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MCGH.NET | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1975 | YearFormation |
| State Legal Domicile | TN | StateLegalDomicile |
| Activity Or Mission Description | THE HOSPITAL'S MISSION IS TO PROVIDE OUR COMMUNITY WITH HIGH QUALITY HEALTHCARE AT A REASONABLE COST WHILE STAYING FINANCIALLY SOUND. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 8 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 182 | TotalNbrEmployees |
| Total Nbr Volunteers | 10 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 62069 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 27456 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 10794796 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 11428283 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 34080 | InvestmentIncomePriorYear |
| Investment Income Current Year | 35967 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1168834 | OtherRevenuePriorYear |
| Other Revenue Current Year | 652756 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 12059779 | TotalRevenuePriorYear |
| Total Revenue Current Year | 12144462 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 6042306 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 6144909 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 5843562 | OtherExpensePriorYear |
| Other Expenses Current Year | 6063989 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 11885868 | TotalExpensesPriorYear |
| Total Expenses Current Year | 12208898 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 173911 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -64436 | RevenuesLessExpensesCY |
| Total Assets BOY | 5631007 | TotalAssetsBOY |
| Total Assets EOY | 5265951 | TotalAssetsEOY |
| Total Liabilities BOY | 1516697 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1216077 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 4114310 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 4049874 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE HOSPITAL'S MISSION IS TO PROVIDE OUR COMMUNITY WITH HIGH QUALITY HEALTHCARE AT A REASONABLE COST WHILE STAYING FINANCIALLY SOUND. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 10364036 | Expense |
| Revenue | 12036388 | Revenue |
| Description | TO PROVIDE INPATIENT, OUTPATIENT AND EMERGENCY SERVICES TO CITIZENS OF MACON COUNTY, TN AND SURROUNDING COUNTIES WITHOUT REGARD TO ABILITY TO PAY, RACE, RELIGION, SEX, NATIONAL ORIGIN, SEXUAL ORIENTATION, ETC. WE PROVIDE CHRONIC DISEASE MANAGEMENT EDUCATION, COMMUNITY OUTREACH AND HEALTH FAIRS TO OVER 7,937 INDIVIDUALS. PROVIDED $120,000 OF CHARITY CARE FOR YEAR ENDED SEPTEMBER 30, 2012. | Description |
| Total Program Service Expense | 10364036 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 34 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 182 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 8 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | THOMAS J KIDD CPA | NamePerson |
| Telephone Number | 6156662147 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 204 MEDICAL DRIVE | AddressLine1 |
| City | LAFAYETTE | City |
| State | TN | State |
| ZIP Code | 37083 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (10 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| CHARLES DARNELL | ||||||
| PRESIDENT | 2.0 | X | X | 1000 | 0 | 0 |
| LINDA AUSTIN | ||||||
| MEMBER | 1.0 | X | 1000 | 0 | 0 | |
| FEMI ODUNUSI MD | ||||||
| MEMBER | 1.0 | X | 1600 | 0 | 0 | |
| HL GOODALL | ||||||
| MEMBER | 1.0 | X | 900 | 0 | 0 | |
| HUGH CLARK | ||||||
| MEMBER | 1.0 | X | 1100 | 0 | 0 | |
| FRED SCRUGGS | ||||||
| MEMBER | 1.0 | X | 1100 | 0 | 0 | |
| RADFORD WEST | ||||||
| VICE-PRESIDENT | 2.0 | X | X | 1000 | 0 | 0 |
| STANLEY CHUNN MD | ||||||
| SECRETARY / TREASURER | 1.0 | X | X | 1325 | 0 | 0 |
| THOMAS KIDD | ||||||
| CFO | 50.0 | X | 0 | 0 | 0 | |
| DENNIS WOLFORD | ||||||
| CEO | 50.0 | X | 0 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 9025 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | false | TotalCompGT150K |
| Compensation From Other Sources | true | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| EM CARE PHYSICIAN SVC | |||||
| 7032 COLLECTION CENTER DR | CHICAGO | IL | 60693 | PHYSICIAN STAFFING | 495847 |
| ALLIANCE IMAGING INC | |||||
| PO BOX 96485 | CHICAGO | IL | 60693 | MRI | 246098 |
| PAINTER HUDSON PHARMACIST | |||||
| 1515 OLD LAKE ROAD | RED BOILING SPRINGS | TN | 37150 | ANESTHSIA SERVICES | 146633 |
| JS ANESTHESIA SVC | |||||
| 165 SPEEDWELL LANE | LEBANON | TN | 37087 | ANESTHESIA SVC. | 113520 |
| QHR | |||||
| 105 CONTINENTAL PLACE | BRENTWOOD | TN | 37027 | MANAGEMENT SERVICES | 510917 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 6 | NumberOfContractorsGT100K |
| Government Grants | 27456 | GovernmentGrants |
| Total Contributions | 27456 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | 11388592 | 11388592 |
| OTHER OPERATING | 621110 | 39691 | 39691 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 11428283 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 35967 | TotalRevenueColumn |
| Exclusion | $35,967 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 38600 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 38600 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 38600 | TotalRevenueColumn |
| Exclusion | $38,600 | ExclusionAmount |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| EHR INCENTIVES | 900099 | 603000 | $603,000 | |
| RESPITE CARE | 624100 | 1125 | 1125 | |
| MASSAGE/WELLNESS | 900099 | 3980 | 3980 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6051 | TotalRevenueColumn |
| Exclusion | $6,051 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 614156 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 12144462 | TotalRevenueColumn |
| Related Or Exempt Function Income | 11433388 | RelatedOrExemptFunctionIncome |
| Exclusion | $683,618 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9025 | Total |
| Management And General | 9025 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4978391 | Total |
| Program Services | 4211682 | ProgramServices |
| Management And General | 766709 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 94836 | Total |
| Program Services | 80085 | ProgramServices |
| Management And General | 14751 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 699005 | Total |
| Program Services | 590284 | ProgramServices |
| Management And General | 108721 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 363652 | Total |
| Program Services | 307090 | ProgramServices |
| Management And General | 56562 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 186800 | Total |
| Management And General | 186800 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 64347 | Total |
| Management And General | 64347 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1578020 | Total |
| Program Services | 1271629 | ProgramServices |
| Management And General | 306391 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18019 | Total |
| Management And General | 18019 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1264492 | Total |
| Program Services | 1133066 | ProgramServices |
| Management And General | 131426 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 155738 | Total |
| Program Services | 155738 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37873 | Total |
| Program Services | 23441 | ProgramServices |
| Management And General | 14432 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32468 | Total |
| Management And General | 32468 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 510876 | Total |
| Program Services | 510876 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 159369 | Total |
| Program Services | 159369 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | FundraisingFundraising | Management And GeneralManagementAndGeneral |
|---|---|---|---|---|
| BAD DEBTS | 1411958 | 1411958 | 0 | |
| REPAIRS & MAINTENANCE | 249017 | 203823 | 45194 | |
| DUES & SUBSCRIPTIONS | 58882 | 24089 | 34793 | |
| MEDICAL SUPPLIES | 271096 | 271090 | 6 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 65034 | Total |
| Program Services | 9816 | ProgramServices |
| Management And General | 55218 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12208898 | Total |
| Program Services | 10364036 | ProgramServices |
| Management And General | 1844862 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 736583 | BOY |
| EOY | 929980 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1082573 | BOY |
| EOY | 1111048 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 988808 | BOY |
| EOY | 1225433 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 173800 | BOY |
| EOY | 184573 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 127990 | BOY |
| EOY | 137705 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 6502176 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 4824964 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2023468 | BOY |
| EOY | 1677212 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 497785 | BOY |
| EOY | 0 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5631007 | BOY |
| EOY | 5265951 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 716817 | BOY |
| EOY | 695840 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 799880 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 520237 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1516697 | BOY |
| EOY | 1216077 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4114310 | BOY |
| EOY | 4049874 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4114310 | BOY |
| EOY | 4049874 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5631007 | BOY |
| EOY | 5265951 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -64436 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $1,130 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 1130 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | LOBBYING EXPENDITURES | Identifier |
| Return Reference | SCH C, PART II-B, LINE 1I | ReturnReference |
| Explanation | A PORTION OF THE DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION AND THE TENNESSEE HOSPITAL ASSOCIATION ARE FOR LOBBYING. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 485487 | OtherCostOrOtherBasis |
| Book Value | 485487 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2185481 | OtherCostOrOtherBasis |
| Depreciation | 2007342 | Depreciation |
| Book Value | 178139 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 40170 | OtherCostOrOtherBasis |
| Depreciation | 39559 | Depreciation |
| Book Value | 611 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3652649 | OtherCostOrOtherBasis |
| Depreciation | 2702889 | Depreciation |
| Book Value | 949760 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 138389 | OtherCostOrOtherBasis |
| Depreciation | 75174 | Depreciation |
| Book Value | 63215 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 1677212 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO THIRD PARTY PAYERS | Description |
| Amount | $520,237 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 520237 | TotalOfAmounts |
| Total Revenue | 12144462 | TotalRevenue |
| Total Expenses | 12208898 | TotalExpenses |
| Excess Or Deficit For Year | -64436 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | -64436 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 10732504 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | -1411958 | OtherRevenues |
| Revenue Not Rptd F990 | -1411958 | RevenueNotRptdF990 |
| Revenue Subtotal | 12144462 | RevenueSubtotal |
| Total Revenue Per Form990 | 12144462 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 10796940 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 10796940 | ExpensesSubtotal |
| Other Expenses Not Included | 1411958 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 1411958 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 12208898 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | INCOME TAXES | Identifier |
| Return Reference | SCH D, PART X, LINE 2 | ReturnReference |
| Explanation | ------------------------------------ THE HOSPITAL HAS BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501 OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. HOWEVER, THE HOSPITAL IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE HOSPITAL FILES TAX RETURNS IN THE U.S. FEDERAL JURISDICTION. WITH A FEW EXCEPTIONS, THE HOSPITAL IS NO LONGER SUBJECT TO U.S. FEDERAL EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2008. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 100 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | false | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | false | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 120178 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 120178 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01110 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2165271 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2165271 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.20050 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2285449 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2285449 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.21160 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2285449 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2285449 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.21160 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $1,411,958 | BadDebtExpenseAmount |
| Amount Attributable To | 593022 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 5713974 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 5191989 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 521985 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | false | WrittenDebtCollectionPolicy |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MACON HOSPITAL INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 204 MEDICAL DRIVE | AddressLine1 |
| City | LAFAYETTE | City |
| State | TN | State |
| ZIP Code | 37083 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MACON HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | false | CHNAConducted |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 100 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 100 | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Average Negotiated Rates | X | AverageNegotiatedRates |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (7 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| BAD DEBTS | SCH H, PART III, LINE 4 | ------------------------------------ THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE DESCRIBING BAD DEBT EXPENSE. THE AMOUNT REPORTED ON LINE 3 RELATES TO THOSE ACCOUNTS WHERE THE HOSPITAL COULD NOT OBTAIN THE NECESSARY PAPERWORK TO PROPERLY CLASSIFY IT AS CHARITY CARE UNDER THE HOSPITAL POLICIES. |
| COSTING METHODOLOGY | SCH H, PART III, LINE 8 | ------------------------------------ THE MEDICARE COST REPORT WAS USED TO DETERMINE LINE 6. |
| NEEDS ASSESSMENT | SCH H, PART VI, LINE 2 | ------------------------------------ MACON COUNTY GENERAL HOSPITAL HAS CONDUCTED A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT AND WE ARE WORKING WITH LOCAL ORGANIZATIONS AND THE COMMUNITY TO IMPLEMENT THE ASSESSMENT. WE ARE ACTIVELY ENGAGED IN PROVIDING FOR AND IMPROVING THE HEALTH OF OUR COMMUNITY. MACON COUNTY, TENNESSEE HAS A STATISTICALLY HIGH PERCENTAGE OF THE POPULATION WITH DIABETES AND MCGH PROVIDES A DIABETES EDUCATION CENTER TO PROVIDE COOKING CLASSES, NUTRITION EDUCATION AND A QUESTION HOTLINE FOR THE COMMUNITY TO MANAGE THEIR DISEASE. MANAGEMENT OF MCGH ARE ALSO LEADERS AND ORGANIZERS OF THE ANNUAL MAKIN' MACON FIT FITNESS FESTIVAL THAT PROMOTES AN ACTIVE LIFESTYLE THAT IS IN IT'S 20TH YEAR. MCGH STAFF WORKS WITH THE MACON COUNTY SCHOOL SYSTEM COORDINATED SCHOOL HEALTH PROGRAM TO PROVIDE CLASSROOM INSTRUCTION ON NUTRITION AND FITNESS TO THE STUDENTS OF THE SCHOOL SYSTEM. MCGH STAFF ARE ON THE BOARDS OF THE SENIOR CITIZEN CENTER, MACON COUNTY HEALTH COUNCIL, MACON COUNTY CHAMBER OF COMMERCE AND THE UPPER MIDDLE TN RURAL HEALTH NETWORK. THROUGH THESE ORGANIZATIONS, WE LEARN OF AND PROVIDE EDUCATION, TRAINING, SCREENINGS AND OTHER ACTIVITIES TO ASSESS AND IMPROVE THE HEALTH NEEDS OF OUR COMMUNITY. |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | SCH H, PART VI, LINE 3 | ------------------------------------ THE REGISTRATION STAFF DESCRIBE AND PROVIDE LITERATURE ABOUT FINANCIAL ASSISTANCE DURING THE PATIENT INTERVIEW PROCESS. EFFORTS ARE MADE TO PUT PATIENTS IN CONTACT WITH RESOURCES AVAILABLE TO ASSIST THE PATIENT IN GETTING QUALIFIED FOR GOVERNMENT OR OTHER ASSISTANCE. APPLICATIONS FOR HOSPITAL CHARITY CARE ARE DISTRIBUTED TO REGISTRARS, BILLING OFFICE STAFF AND A SOCIAL WORKER. POSTED NOTICES ARE OTHER SOURCES OF INFORMATION. |
| COMMUNITY INFORMATION | SCH H, PART VI, LINE 4 | ------------------------------------ MACON COUNTY, TN HAD A 2010 POPULATION OF 22,248 CITIZENS. THE HOSPITAL SERVES PRIMARILY MACON COUNTY AND PATIENTS CLOSE TO THE BORDER OF MACON COUNTY. THE MEDIAN HOUSEHOLD INCOME IN 2000 WAS $29,867 WITH AN ESTIMATED 15.1% OF THE COUNTY'S POPULATION LIVING IN POVERTY. THE COUNTY COVERS 307 SQUARE MILES AND IS BOTH A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) AND A MEDICALLY UNDERSERVED AREA/POPULATION (MUA/P). |
| PROMOTION OF COMMUNITY HEALTH | SCH H, PART VI, LINE 5 | ------------------------------------ MACON COUNTY GENERAL HOSPITAL'S DEDICATED STAFF VOLUNTEER FOR NUMEROUS CAUSES PROMOTING HEALTH AND WELFARE FOR MACON COUNTY INCLUDING: RELAY FOR LIFE, MAKIN' MACON FIT FITNESS FESTIVAL, MAMMOGRAPHY SCREENINGS, BREAST CANCER AWARENESS EVENTS, SENIOR CITIZENS CENTER EDUCATION AND SCREENINGS, LOCAL RADIO WEEKLY SHOW ON HEALTH ISSUES AND HOW TO TAKE PREVENTATIVE MEASURE, MACON COUNTY CO-ORDINATED SCHOOL HEALTH PROGRAM, MACON COUNTY HEALTH COUNCIL, MACON COUNTY CHAMBER OF COMMERCE AND TEH MACON COUNTY EDUCATION FOUNDATION. THE MEDICAL STAFF IS OPEN TO ANY PHYSICIAN WHO MEETS CREDENTIALING STANDARDS AND AGREES TO STANDARDS ESTABLISHED BY THE MEDICAL STAFF. VARIOUS BUSINESS LEADERS SERVE ON THE BOARD OF DIRECTORS ALONG WITH LEADERS OF THE PHYSICIAN COMMUNITY. SURPLUS FUNDS PROVIDE FOR CONTINUITY OF HEALTHCARE SERVICES DURING PERIODS OF ECONOMIC DOWNTURN AND ARE REINVESTED IN NEW TECHNOLOGY AND EQUIPMENT AS NEEDED. |
| COMMUNITY INPUT | SCH. H, PART V, SECTION B, LINE 3 | ------------------------------------ STATE OF TENNESSEE DEPARTMENT OF HEALTH, MACON COUNTY GENERAL HOSPITAL, MACON COUNTY SCHOOL SYSTEM, PRIMARY CARE PROVIDERS, UNIVERSITY OF TENNESSEE EXTENSION SERVICE, MACON COUNTY SENIOR CITIZENS CENTER AND LOCAL INDIVIDUALS AND COMMUNITY LEADERS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| THOMAS KIDD | |||||||||||||
| 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| DENNIS WOLFORD | |||||||||||||
| 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | COMPENSATION FROM UNRELATED ORGANIZATION | Identifier |
| Return Reference | SCH J, PART II | ReturnReference |
| Explanation | ------------------------------------ THE HOSPITAL CONTRACTS THE SERVICES OF DENNIS WOLFORD (CEO) AND THOMAS KIDD (CFO) WITH QHR (FORMERLY QUORUM HEALTH RESOURCES, INC.), AN UNRELATED ORGANIZATION. QHR was paid $323,917 for services provided by these individuals for the fiscal year ending September 30, 2012. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DELEGATION OF CONTROL TO A MANAGEMENT COMPANY OR OTHER PERSON | FORM 990, PART VI, QUESTION 3 | ------------------------------------ THE HOSPITAL CONTRACTS CERTAIN MANAGEMENT AND ADMINISTRATIVE SERVICES WITH QHR (FORMERLY QUORUM HEALTH RESOURCES, INC.). UNDER TERMS OF THE AGREEMENT, QHR PROVIDES THE SERVICES OF A CEO, CFO, AND ALSO PROVIDES OTHER ADMINISTRATIVE SERVICES CONSISTENT WITH THE POLICIES AND DIRECTIVES DICTATED BY THE BOARD OF DIRECTORS. For fiscal year ending September 30, 2012, Macon County Hospital paid QHR $138,353 for the services of Thomas Kidd (CFO) and $185,564 for the services of Dennis Wolford (CEO). PER IRS GUIDANCE, NO COMPENSATION IS SHOWN ON FORM 990, PART VII, FOR THE CEO AND CFO. |
| PROCESS TO REVIEW THE FORM 990 | FORM 990, PART VI, QUESTION 11B | ------------------------------------ A COPY OF THE FORM 990 WILL BE PROVIDED TO THE FULL BOARD AT A BOARD MEETING PRIOR TO FILING. |
| PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY | FORM 990, PART VI, QUESTION 12C | ------------------------------------ ALL EMPLOYEES OF THE HOSPITAL ARE COVERED AND REVIEWED BY THE COMPLIANCE OFFICER. ANY EMPLOYEES HAVING A CONFLICT OF INTEREST ARE NOT ALLOWED TO PARTICIPATE IN THE DECISION MAKING REGARDING ANY ACTIVITY THAT WOULD BE VIEWED AS A CONFLICT OF INTEREST. |
| PROCESS FOR DETERMINING COMPENSATION | FORM 990, PART VI, QUESTIONs 15A & 15B | ------------------------------------ THE REVIEW IS CONDUCTED BY QHR THAT SHOWS THE MINIMUM, MEDIAN AND MAXIMUM SALARY FOR THE SAME POSITION AT SIMILAR ORGANIZATIONS IN SIZE AND VOLUME. THE BOARD THEN TAKES THIS INFORMATION AND SETS THE SALARY FOR THE CEO AND CFO. |
| MAKING DOCUMENTS AVAILABLE TO THE PUBLIC | FORM 990, PART VI, LINE 19 | ------------------------------------ THE ORGANIZATION'S FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS ARE STORED IN ADMINISTRATION AND AVAILABLE UPON REQUEST. |
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